Endoscopic Screening for Gastric Cancer Yock Young Dan, J.B.Y. So, Khay Guan Yeoh  Clinical Gastroenterology and Hepatology  Volume 4, Issue 6, Pages 709-716 (June 2006) DOI: 10.1016/j.cgh.2006.03.025 Copyright © 2006 American Gastroenterological Association Terms and Conditions

Figure 1 Epidemiology of gastric cancer in Singapore (ASR, 21.6/100,000). (A) Comparison of incidence of gastric cancer by race and sex. The Chinese male population has the highest incidence at 25.7/100,000, 3-fold higher than the Indians or Malays. (B) Incidence of gastric cancer by age group and sex. Incidence rises exponentially from 50 years of age. The highest risk population would be the Chinese male population after 50 years of age. Clinical Gastroenterology and Hepatology 2006 4, 709-716DOI: (10.1016/j.cgh.2006.03.025) Copyright © 2006 American Gastroenterological Association Terms and Conditions

Figure 2 Sensitivity analysis on incidence of gastric cancer (ASR and cost of screening [USD]). When the incidence of gastric cancer is low and cost of screening endoscopy is high, such as in the US, screening is not cost-effective. In contrast, when incidence is high like in Japan, it is highly cost-effective, even if screening cost is high. Clinical Gastroenterology and Hepatology 2006 4, 709-716DOI: (10.1016/j.cgh.2006.03.025) Copyright © 2006 American Gastroenterological Association Terms and Conditions

Figure 3 Comparing different strategies of screening. The ICER between different strategies is presented. Although HP screening/eradication followed by selective endoscopy has the lowest cost, they are offset by lower number of cancer deaths averted. Strategy of screening for the whole population or the male population is extendedly dominated (more expensive yet less effective compared with screening Chinese men). Clinical Gastroenterology and Hepatology 2006 4, 709-716DOI: (10.1016/j.cgh.2006.03.025) Copyright © 2006 American Gastroenterological Association Terms and Conditions